Association Between Nutrient Canal Presence and Trabecular Bone Changes Around Jaw Cysts: A Comparative CBCT Study

Objective: This study aimed to investigate the relationship between the presence of nutrient canals and potential trabecular bone changes in jaws with or without cysts, using two different classification methods. Materials and Methods: CBCT images from 60 patients with unilateral jaw cysts located in either the maxilla or mandible were reviewed retrospectively. Cyst-affected sides with or without nutrient canals were grouped and compared to all unaffected sides combined. Trabecular bone quality was assessed both qualitatively (visual trabecular pattern classification) and quantitatively (modified Lekholm and Zarb classification based on HU ranges). Fisher’s Exact and Fisher-Freeman-Halton tests were used to compare frequencies between groups. Intra-observer reliability was assessed using Kappa statistics. Significance was set at p < 0.05.Results: Nutrient canals were significantly associated with sclerotic trabecular bone patterns in cyst-affected regions (p = 0.001), with nutrient canals more frequent in areas of “average” or “above-average” trabecular density. Nutrient canals also showed a significant association with the highest bone density category (Q1) in both cystic (p < 0.001) and non-cystic regions (p = 0.003). A significant association was observed between qualitative and quantitative classifications (p < 0.001). Intra-observer reliability was moderate for visual trabecular assessments and high for the quantitative classification.Conclusion: Sclerotic changes in the trabecular bone around jaw cysts are closely associated with occurrence of nutrient canals, potentially reflecting compensatory vascular adaptation. Nutrient canals should be clearly documented in CBCT reports. The modified Lekholm and Zarb classification may serve as a reliable alternative to visual methods for assessing bone quality on CBCT images.